Agreement between nutritional status and perception of body image in indigenous Khisêdjê of the Xingu Indigenous Park. / Concordância entre estado nutricional e percepção da imagem corporal em indígenas khisêdjê do Parque Indígena do Xingu.

OBJECTIVE: To determine the agreement between body self-image (based on the Stunkard figure rating scale) and nutritional status and to evaluate body satisfaction among the Khisêdjê indigenous people of Parque Indígena do Xingu (Xingu Indigenous Park). METHODS: A cross-sectional study involving 131 natives aged 20 and older. Data on body image, body mass index and waist circumference were collected. Kappa statistics, χ2 (p < 0.05), crude and adjusted prevalence ratios and Student's t-test were used for data analysis. RESULTS: The prevalence of overweight and obesity was respectively 42 and 5.3%. The percentage of satisfaction with body profile was 61.8% with no difference between the sexes. There was good agreement between actual and ideal self-image (p < 0.001), but poor agreement between actual and ideal self-image with nutritional status for both sexes. A higher prevalence of body dissatisfaction due to overweight was detected in individuals with central obesity and overweight. CONCLUSION: The results suggest that body self-image evaluated by the Stunkard silhouette scale has little applicability as an indicator of nutritional status among the indigenous Khisêdjê of Xingu Indigenous Park.

Concordância entre estado nutricional e percepção da imagem corporal em indígenas khisêdjê do Parque Indígena do Xingu / Agreement between nutritional status and perception of body image in indigenous Khisêdjê of the Xingu Indigenous Park

RESUMO: Objetivos: Verificar a concordância entre autoimagem corporal (escala de silhuetas de Stunkard et al.) e estado nutricional e avaliar a satisfação corporal em indígenas khisêdjê do Parque Indígena do Xingu. Métodos: Estudo transversal que incluiu 131 indígenas khisêdjê, com 20 anos ou mais. Coletaram-se dados sobre imagem corporal, índice de massa corporal e perímetro da cintura. Foram utilizados a estatística kappa, o teste χ2 (p < 0,05), as razões de prevalências brutas e ajustadas e o teste t de Student. Resultados: As prevalências de sobrepeso e obesidade foram, respectivamente, 42 e 5,3%. A porcentagem de satisfação com o perfil corporal foi de 61,8%, sem diferença entre os sexos. Houve boa concordância entre autoimagem real e autoimagem ideal (p < 0,001), porém baixa concordância entre a autoimagem real e ideal e o estado nutricional para ambos os sexos. Maior prevalência de insatisfação corporal por excesso de peso foi detectada entre indivíduos com obesidade central e excesso de peso. Conclusão: Os resultados sugerem que a autoimagem corporal avaliada por meio da escala de silhuetas de Stunkard et al. tem pouca aplicabilidade como indicador do estado nutricional de indígenas khisêdjê do Parque Indígena do Xingu.

ABSTRACT: Objective: To determine the agreement between body self-image (based on the Stunkard figure rating scale) and nutritional status and to evaluate body satisfaction among the Khisêdjê indigenous people of Parque Indígena do Xingu (Xingu Indigenous Park). Methods: A cross-sectional study involving 131 natives aged 20 and older. Data on body image, body mass index and waist circumference were collected. Kappa statistics, χ2 (p < 0.05), crude and adjusted prevalence ratios and Student's t-test were used for data analysis. Results: The prevalence of overweight and obesity was respectively 42 and 5.3%. The percentage of satisfaction with body profile was 61.8% with no difference between the sexes. There was good agreement between actual and ideal self-image (p < 0.001), but poor agreement between actual and ideal self-image with nutritional status for both sexes. A higher prevalence of body dissatisfaction due to overweight was detected in individuals with central obesity and overweight. Conclusion: The results suggest that body self-image evaluated by the Stunkard silhouette scale has little applicability as an indicator of nutritional status among the indigenous Khisêdjê of Xingu Indigenous Park.

Risk factors for cardiovascular disease in HIV/AIDS patients treated with highly active antiretroviral therapy (HAART) in the central-southern region of the state of Paraná - Brazil.

The aim of this study was to describe metabolic changes in HIV/AIDS patients according to the treatment regimen. It was a retrospective cohort conducted from 2002 to 2014. Researchers surveyed clinical variables and treatment regimen of 538 individuals. They used measures of central tendency and marginal logistic regression to determine the influence of the treatment regimen on clinical variables over time; survival was estimated using Kaplan-Meier curves. 56.2% of patients were male, 82.2% white, 33.8% had 4 to 7 years of study, 49.2% were married, 98.5% had sexual transmission, and 89.0% were heterosexuals. During the study period, 24.4% had hypertension, 18.2% changed cholesterol, 39.7% low HDL, 51.3% high triglycerides and 33.3% hyperglycemia. Treatment regimens with nucleotide reverse transcriptase inhibitors associated with protease inhibitors, and the association of different classes of antiretrovirals have been associated with greater lipid changes. Higher metabolic changes were observed in patients with longer treatment time. It is concluded that preventive measures, as well as early treatment, can contribute to minimize the risks of developing cardiovascular diseases.

Risk factors for cardiovascular disease in HIV/AIDS patients treated with highly active antiretroviral therapy (HAART) in the central-southern region of the state of Paraná - Brazil / Fatores de risco para doença cardiovascular em pacientes com HIV / AIDS tratados com terapia antirretroviral altamente ativa (HAART) na região centro-sul do estado do Paraná-Brasil

Abstract The aim of this study was to describe metabolic changes in HIV/AIDS patients according to the treatment regimen. It was a retrospective cohort conducted from 2002 to 2014. Researchers surveyed clinical variables and treatment regimen of 538 individuals. They used measures of central tendency and marginal logistic regression to determine the influence of the treatment regimen on clinical variables over time; survival was estimated using Kaplan-Meier curves. 56.2% of patients were male, 82.2% white, 33.8% had 4 to 7 years of study, 49.2% were married, 98.5% had sexual transmission, and 89.0% were heterosexuals. During the study period, 24.4% had hypertension, 18.2% changed cholesterol, 39.7% low HDL, 51.3% high triglycerides and 33.3% hyperglycemia. Treatment regimens with nucleotide reverse transcriptase inhibitors associated with protease inhibitors, and the association of different classes of antiretrovirals have been associated with greater lipid changes. Higher metabolic changes were observed in patients with longer treatment time. It is concluded that preventive measures, as well as early treatment, can contribute to minimize the risks of developing cardiovascular diseases.

Resumo O objetivo deste estudo foi descrever os fatores de risco cardiovascular em pacientes HIV/AIDS de acordo com o esquema terapêutico utilizado. Estudo de Coorte retrospectiva no período de 2002 a 2014. Foram levantadas variáveis clínicas e esquema de tratamento de 538 indivíduos. Utilizaram-se medidas de tendência central, e regressão marginal logística para verificar a influência do esquema de tratamento sobre variáveis clinicas ao longo do tempo. Dos pacientes, 56,2% eram homens, 82,2% brancos, 33,8% tinham entre 4 a 7 anos de estudo, 49,2% eram casados, 98,5% tiveram transmissão sexual e 89,0% eram heterossexuais. A idade média no diagnóstico foi de 36,3 anos. Durante o período de estudo, 24,4% hipertensão arterial, 18,2% colesterol alterado, 39,7% HDL baixo, 51,3% triglicerídeos elevados e 33,3% hiperglicemia. Os esquemas de tratamento com Inibidores da transcriptase reversa nucleotídeos associados a inibidores da protease, e a associação de diferentes classes de antirretrovirais estiveram associados a maiores alterações lipídicas e maiores alterações metabólicas com maior tempo de tratamento. Conclui-se que medidas preventivas, bem como tratamento precoce pode contribuir para minimizar os riscos de desenvolvimento de doenças cardiovasculares.

Mindfulness as a complementary intervention in the treatment of overweight and obesity in primary health care: study protocol for a randomised controlled trial.

BACKGROUND: Mindfulness has been applied in the United States and Europe to improve physical and psychological health; however, little is known about its feasibility and efficacy in a Brazilian population. Mindfulness may also be relevant in tackling obesity and eating disorders by decreasing binge eating episodes-partly responsible for weight regain for a large number of people-and increasing awareness of emotional and other triggers for overeating. The aim of the present study protocol is to evaluate and compare the feasibility and efficacy of two mindfulness-based interventions (MBIs) addressing overweight and obesity in primary care patients: a general programme called Mindfulness-Based Health Promotion and a targeted mindful eating protocol called Mindfulness-Based Eating Awareness Training. METHODS/DESIGN: A randomised controlled trial will be conducted to compare treatment as usual separately in primary care with both programmes (health promotion and mindful eating) added to treatment as usual. Two hundred forty adult women with overweight and obesity will be enrolled. The primary outcome will be an assessment of improvement in eating behaviour. Secondary outcomes will be (1) biochemical control; (2) anthropometric parameters, body composition, dietary intake and basal metabolism; and (3) levels of mindfulness, stress, depression, self-compassion and anxiety. At the end of each intervention, a focus group will be held to assess the programme's impact on the participants' lives, diet and health. A feasibility study on access to benefits from and importance of MBIs at primary care facilities will be conducted among primary care health care professionals and participants. Monthly maintenance sessions lasting at least 1 hour will be offered, according to each protocol, during the 3-month follow-up periods. DISCUSSION: This clinical trial will result in more effective mindfulness-based interventions as a complementary treatment in primary care for people with overweight and obesity. If the findings of this study confirm the effectiveness of mindfulness programmes in this population, it will be possible to improve quality of life and health while optimising public resources and reaching a greater number of people. In addition, on the basis of the evaluation of the feasibility of implementing this intervention in primary care facilities, we expect to be able to suggest the intervention for incorporation into public policy. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02893150 . Registered retrospectively on 30 March 2017.

Incidence of vertebral fractures in calcium and vitamin D-supplemented postmenopausal Brazilian women with osteopenia or osteoporosis: data from Arzoxifene Generations Trial.

OBJECTIVE: Vertebral fracture is the most common osteoporotic fracture, affecting quality of life and increasing mortality. Epidemiological data on incidence of vertebral fracture are scarce in Brazil and throughout Latin America. Our aim was to determine vertebral fracture incidence and risk factors in a female Brazilian population. SUBJECTS AND METHODS: Postmenopausal women with low bone mass were studied from the Brazilian placebo group of Arzoxifene Generations Trial (n = 974), followed for up to 5 years. The primary endpoint was new vertebral fractures, detected by X-Ray. Experimental design defined two strata: A. Osteoporosis or previous vertebral fracture with osteopenia; B. Osteopenia without previous fracture. Previous fracture, T-score, ionized calcium, alkaline phosphatase, creatinine and glucose were analyzed at baseline. Crude and adjusted incidence rates of vertebral fractures were estimated and Poisson regression model was used. RESULTS: Incidence rate was 7.7 (95% CI of 5.4 to 10.9) per 1,000 person-years (PY), increasing as a function of age. Women with new vertebral fractures had higher prevalence of previous nonvertebral fracture after menopause, were older and had lower lumbar spine (LS) T-score. Fracture risk increased by 46% for each unit reduction in LS T-score. Variables correlated with new vertebral fracture were age (p = 0.034), LS T-score, stratum A (p = 0.001 for both) and previous nonvertebral fracture after menopause (p = 0.019). In the final model, LS T-score was the strongest predictor. CONCLUSIONS: Incidence rate of vertebral fracture of 7.7 per 1,000 PY. Age and previous fractures were associated with new vertebral fracture, but LS T-score was the most important predictor.

Incidence of vertebral fractures in calcium and vitamin D-supplemented postmenopausal Brazilian women with osteopenia or osteoporosis: data from Arzoxifene Generations Trial

ABSTRACT Objective Vertebral fracture is the most common osteoporotic fracture, affecting quality of life and increasing mortality. Epidemiological data on incidence of vertebral fracture are scarce in Brazil and throughout Latin America. Our aim was to determine vertebral fracture incidence and risk factors in a female Brazilian population. Subjects and methods Postmenopausal women with low bone mass were studied from the Brazilian placebo group of Arzoxifene Generations Trial (n = 974), followed for up to 5 years. The primary endpoint was new vertebral fractures, detected by X-Ray. Experimental design defined two strata: A. Osteoporosis or previous vertebral fracture with osteopenia; B. Osteopenia without previous fracture. Previous fracture, T-score, ionized calcium, alkaline phosphatase, creatinine and glucose were analyzed at baseline. Crude and adjusted incidence rates of vertebral fractures were estimated and Poisson regression model was used. Results Incidence rate was 7.7 (95% CI of 5.4 to 10.9) per 1,000 person-years (PY), increasing as a function of age. Women with new vertebral fractures had higher prevalence of previous nonvertebral fracture after menopause, were older and had lower lumbar spine (LS) T-score. Fracture risk increased by 46% for each unit reduction in LS T-score. Variables correlated with new vertebral fracture were age (p = 0.034), LS T-score, stratum A (p = 0.001 for both) and previous nonvertebral fracture after menopause (p = 0.019). In the final model, LS T-score was the strongest predictor. Conclusions Incidence rate of vertebral fracture of 7.7 per 1,000 PY. Age and previous fractures were associated with new vertebral fracture, but LS T-score was the most important predictor.

Food and Nutrition Surveillance System/SISVAN: getting to know the feeding habits of infants under 24 months of age.

The objective of the Food and Nutrition Surveillance System (SISVAN) is to monitor the food intake of individuals attended by the Brazilian Unified Health System (SUS). The objective of this research was to identify the feeding practices of children under 24 months of age who were attended at Primary Healthcare Units (UBS), using SISVAN, and to assess the relationship with maternal sociodemographic profiles. A cross-sectional study was conducted in order to evaluate 350 children using the Food Consumption Marker Form of SISVAN, and maternal demographic data to identify sociodemographic profiles by exploratory factor analysis. Of the children assessed, 41.1% were under 6 months of age and 98.7% of those between 6 and 23 months had an inadequate intake. Two sociodemographic profiles were found: Profile 1 (mothers with lower income, less education, and recipients of the 'Bolsa Família' conditional family grant program) associated with the consumption of water/tea, cow's milk and salty baby food; and Profile 2 (older mothers with many children and with a larger number of residents in the household) associated with breast milk consumption (p = 0.048). The use of SISVAN made it possible to identify that children had inadequate feeding practices, and Profile 1 appears to be a risk profile for weaning.

Food and Nutrition Surveillance System/SISVAN: getting to know the feeding habits of infants under 24 months of age / Sistema de Vigilância Alimentar e Nutricional/SISVAN: conhecendo as práticas alimentares de crianças menores de 24 meses

The objective of the Food and Nutrition Surveillance System (SISVAN) is to monitor the food intake of individuals attended by the Brazilian Unified Health System (SUS). The objective of this research was to identify the feeding practices of children under 24 months of age who were attended at Primary Healthcare Units (UBS), using SISVAN, and to assess the relationship with maternal sociodemographic profiles. A cross-sectional study was conducted in order to evaluate 350 children using the Food Consumption Marker Form of SISVAN, and maternal demographic data to identify sociodemographic profiles by exploratory factor analysis. Of the children assessed, 41.1% were under 6 months of age and 98.7% of those between 6 and 23 months had an inadequate intake. Two sociodemographic profiles were found: Profile 1 (mothers with lower income, less education, and recipients of the 'Bolsa Família' conditional family grant program) associated with the consumption of water/tea, cow's milk and salty baby food; and Profile 2 (older mothers with many children and with a larger number of residents in the household) associated with breast milk consumption (p = 0.048). The use of SISVAN made it possible to identify that children had inadequate feeding practices, and Profile 1 appears to be a risk profile for weaning.

O Sistema de Vigilância Alimentar e Nutricional (SISVAN) objetiva monitorar as características do consumo alimentar de indivíduos atendidos pelo Sistema Único de Saúde. O objetivo deste estudo foi identificar as práticas alimentares de crianças menores de 24 meses que frequentam Unidades Básicas de Saúde (UBS), utilizando o SISVAN, e avaliar a relação com perfis sociodemográficos maternos. Estudo transversal que avaliou 350 crianças utilizando-se o Formulário de Marcadores de Consumo Alimentar do SISVAN, e dados sociodemográficos maternos para a identificação dos perfis a partir da análise fatorial exploratória. Das crianças avaliadas, 41,1% das menores de 6 meses e 98,7% daquelas entre 6 e 23 meses apresentaram consumo inadequado. Foram encontrados 2 perfis sociodemográficos: Perfil 1 (mães com menor renda, menor escolaridade e beneficiárias do Programa Bolsa Família) associado com o consumo de água/chá, leite de vaca e papa salgada; e Perfil 2 (mães com mais idade, com maior número de filhos e com maior número de residentes no domicílio) associado com o consumo de leite materno (p= 0,048). A utilização do SISVAN possibilitou identificar que as crianças apresentaram práticas alimentares inadequadas, e o Perfil 1 parece ser um perfil de risco para o desmame.

Mortalidade por doenças cardiovasculares segundo gênero e idade no Estado do Paraná, Brasil: 1979 a 1981 e 2006 a 2008 / Cardiovascular mortality by gender and age in the State of Paraná, Brazil: 1979 to 1981 and 2006 to 2008

OBJETIVOS: Neste estudo epidemiológico do tipo ecológico, comparou-se a mortalidade pelas doenças cardiovasculares no estado do Paraná entre os triênios 1979-1981 e 2006-2008. MÉTODOS: Os dados das mortes por doenças cardiovasculares ocorridas no estado do Paraná no período de 1979 a 2008 foram obtidos do Sistema de Informação sobre Mortalidade do Ministério da Saúde. A magnitude da mortalidade e a mudança entre os triênios foram descritos por meio dos coeficientes de mortalidade e pela variação percentual relativa. Utilizou-se o modelo de regressão de Poisson para estimar a mudança de mortalidade entre os períodos. RESULTADOS: Durante o período de investigação, verificou-se, independentemente da idade e do gênero, redução na ocorrência de mortes por doenças cardiovasculares. Em ambos os gêneros, os coeficientes de mortalidade aumentaram com o aumento da idade. Entre os homens, a mortalidade por doença isquêmica cardíaca foi maior que por doenças cerebrovasculares. CONCLUSÃO: A diminuição da mortalidade pelo conjunto das doenças cardiovasculares pode significar mais acesso a serviços e métodos diagnósticos e terapêuticos. .

OBJECTIVES: In this epidemiological ecological study, it was compared the mortality from cardiovascular disease in the state of Paraná, between the three-year periods 1979-1981 and 2006-2008. METHODS: Data of cardiovascular deaths occurred in the state of Paraná in the period 1979-2008 were obtained from the Mortality Information System of the Ministry of Health. The magnitude of mortality and the change between the triennium were described using the mortality rates and the relative percentage variation. The Poisson regression model to estimate the change in mortality between the periods was used. RESULTS: During the investigation, it was found, regardless of age and gender, reduction in the occurrence of cardiovascular deaths. In both genders, the mortality rates increased with increasing age. Among men, mortality from ischemic heart disease was higher than for cerebrovascular diseases. CONCLUSION: The decrease in mortality for the group of cardiovascular diseases may mean greater access to services and diagnostic and therapeutic methods. .

Incidence of metabolic syndrome and related diseases in the Khisêdjê indigenous people of the Xingu, Central Brazil, from 1999-2000 to 2010-2011.

The aim of this study was to identify the incidence of metabolic syndrome and related diseases in the Khisêdjê population living in the Xingu Indigenous Park, Mato Grosso State, Brazil, from 1999-2000 to 2010-2011. The study included 78 individuals aged ≥20 years. Data were analyzed using Student t test, linear regression, and Poisson regression. In 10 years of follow-up, cumulative incidence rates were 37.5% for metabolic syndrome, 47.4% for hypetriglyceridemia, 38.9% for arterial hypertension, 32% for central obesity, 30.4% for excess weight, 29.1% for hypercholesterolemia, 25% for low HDLc, 10.4% for high LDLc, and 2.9% for diabetes mellitus. Age proved to be a risk factor for incidence of hypertension, diabetes, and elevated LDLc, regardless of gender; male gender was a protective factor against incidence of central obesity, independently of age. The study showed deterioration of most target health indicators and exposure of the Khisêdjê to high cardiometabolic risk. These results may be related to changes in traditional lifestyle.

Prevalência de atipias citológicas e infecção pelo papilomavírus humano de alto risco em mulheres indígenas Panará, povo indígena do Brasil Central / Prevalence of cytological atypia and high-risk human papillomavirus infection in Panará indigenous women in Central Brazil / Prevalencia de atipias citológicas e infección por el virus del papiloma humano de alto riesgo en mujeres indígenas Panará, pueblo indígena de Brasil Central

O objetivo do estudo foi analisar a prevalência das atipias citológicas e infecção pelo papilomavírus humano em mulheres indígenas Panará no período de 2006 a 2007. Trata-se de estudo observacional transversal, com dados obtidos por coleta de amostras cérvico-vaginais para colpocitologia oncótica e captura híbrida, exame de colposcopia e biópsia. O trabalho incluiu 86 mulheres com idades de 12 anos ou mais, com história de vida sexual ativa ou pregressa. Os resultados mostraram que 10,7% das mulheres tinham atipias citológicas e que 28,6% estavam infectadas pelo HPV de alto risco oncogênico, principalmente entre as mais jovens (média = 25,6 anos). Dessas, 41,7% foram positivas para um ou mais dos tipos de HPV de alto risco dos genótipos 16, 18 ou 45, e a maioria, 58,3%, para outros tipos de HPV de alto risco. Conclui-se que é uma população especial, susceptível ao desenvolvimento das lesões precursoras do câncer do colo do útero e vulnerável às DST. Medidas preventivas como o rastreamento populacional sistemático para o câncer cervical e imunização contra o HPV são necessárias.

The aim of this study was to analyze the prevalence of cytological atypia and human papillomavirus infection in Panará indigenous women in 2006-2007. This was a cross-sectional observational study with data obtained from vaginal cervical samples for Pap smear and hybrid capture, colposcopy, and biopsy. The study included 86 females 12 years or older with a history of sexual activity. 10.7% of the women were diagnosed with cytological atypia and 28.6% were infected with high-risk HPV genotypes, which were more common among young women (mean = 25.6 years). Of these, 41.7% were positive for high-risk HPV genotypes 16 and/or 18 and/or 45, and the majority (58.3%) for other high-risk HPV genotypes. The study concludes that this group of indigenous women constitutes a special population, susceptible to develop precursor lesions for cervical cancer and vulnerable to STDs. Preventive measures are required, such as systematic cervical cancer screening and HPV immunization.

El objetivo del estudio fue analizar la prevalencia de atipias citológicas y la infección por el virus del papiloma humano en mujeres indígenas, Panará, durante el periodo 2006-2007. Se trata de estudio observacional, transversal, descriptivo, con datos obtenidos de la recogida de muestras cervicovaginales para examen de Papanicolaou y captura híbrida, además del examen de colposcopia y biopsia. El estudio incluyó a 86 mujeres de 12 años o mayores con antecedentes de actividad sexual actual o pasada. Los resultados mostraron una prevalencia de un 10,7% en mujeres con atipias citológicas y un 28,6% de infección por VPH de alto riesgo, particularmente entre las mujeres jóvenes (promedio 26,5 años). De estas, un 41,7% fueron positivas en uno o más de los tipos de VPH de alto riesgo (16/18/45) y un 58,3% en otros tipos de VPH de alto riesgo. Llegamos a la conclusión de que es una población particularmente susceptible al desarrollo de lesiones precursoras del cáncer de cuello de útero y, por ello, se requieren medidas preventivas como: pruebas de Papanicolaou de forma sistemática y campañas de vacunación.

Incidence of metabolic syndrome and related diseases in the Khisêdjê indigenous people of the Xingu, Central Brazil, from 1999-2000 to 2010-2011 / Incidência de síndrome metabólica e doenças associadas na população indígena Khisêdjê do Xingu, Brasil Central, no período de 1999-2000 a 2010-2011 / Incidência de síndrome metabólica e doenças associadas na população indígena Khisêdjê do Xingu, Brasil Central, no período de 1999-2000 a 2010-2011 / Incidencia del síndrome metabólico y enfermedades relacionadas en la población indígena Khisêdjê del Xingú, Brasil Central, de 1999-2000 a 2010-2011

The aim of this study was to identify the incidence of metabolic syndrome and related diseases in the Khisêdjê population living in the Xingu Indigenous Park, Mato Grosso State, Brazil, from 1999‐2000 to 2010‐2011. The study included 78 individuals aged ≥20 years. Data were analyzed using Student t test, linear regression, and Poisson regression. In 10 years of follow-up, cumulative incidence rates were 37.5% for metabolic syndrome, 47.4% for hypetriglyceridemia, 38.9% for arterial hypertension, 32% for central obesity, 30.4% for excess weight, 29.1% for hypercholesterolemia, 25% for low HDLc, 10.4% for high LDLc, and 2.9% for diabetes mellitus. Age proved to be a risk factor for incidence of hypertension, diabetes, and elevated LDLc, regardless of gender; male gender was a protective factor against incidence of central obesity, independently of age. The study showed deterioration of most target health indicators and exposure of the Khisêdjê to high cardiometabolic risk. These results may be related to changes in traditional lifestyle.

El objetivo del estudio fue identificar la incidencia del síndrome metabólico y de enfermedades asociadas en la población Khisêdjê, que reside en el Reserva Indígena de Xingú, Mato Grosso, Brasil, durante los años de 1999‐2000 a 2010‐2011. Fueron incluidos 78 individuos con edad ≥20 años. Los datos fueron evaluados a través de las pruebas estadísticas t de Student, regresión lineal múltiple y regresión de Poisson. La incidencia acumulada en los 10 años de seguimiento fue de 37,5% de síndrome metabólico, 47,4% de hipertrigliceridemia, 38,9% de hipertensión arterial y 32% de obesidad central. Independientemente del sexo, la edad está relacionada como factor de riesgo para la incidencia de hipertensión arterial, diabetes mellitus, y LDLc elevado. Ser de sexo masculino se constituye en un factor de protección para la incidencia de obesidad central, independientemente de la edad. Fueron identificados deterioros significativos en gran parte de los indicadores de salud evaluados en los Khisêdjê expuestos a riesgo cardiometabólico elevado. Este resultado puede estar relacionado con la alteración del estilo de vida tradicional de la población estudiada.

O objetivo deste estudo foi identificar a incidência de síndrome metabólica e doenças associadas na população Khisêdjê, residente no Parque Indígena do Xingu, Mato Grosso, Brasil, ao longo do período de 1999‐2000 a 2010‐2011. Foram incluídos 78 indivíduos com idades ≥20 anos. Os dados foram avaliados por meio do teste t de Student, regressão linear múltipla e regressão de Poisson. Em dez anos de seguimento verificou-se a incidência acumulada de 37,5% de síndrome metabólica, 47,4% de hipetrigliceridemia, 38,9% de hipertensão arterial, 32% de obesidade central, 30,4% de excesso de peso, 29,1% de hipercolesterolemia, 25% de baixo HDLc, 10,4% de elevado LDLc e 2,9% de diabetes mellitus. A idade foi identificada como um fator de risco para incidência de hipertensão arterial, diabetes mellitus e elevado LDLc, independentemente do sexo; ser do sexo masculino foi fator de proteção para incidência de obesidade central, não importando a idade. Identificou-se deterioração de grande parte dos indicadores de saúde avaliados, estando os Khisêdjê expostos a elevado risco cardiometabólico. Esse resultado pode estar relacionado a alterações no estilo de vida tradicional.

[Prevalence of cytological atypia and high-risk human papillomavirus infection in Panará indigenous women in Central Brazil]. / Prevalência de atipias citológicas e infecção pelo papilomavírus humano de alto risco em mulheres indígenas Panará, povo indígena do Brasil Central.

The aim of this study was to analyze the prevalence of cytological atypia and human papillomavirus infection in Panará indigenous women in 2006-2007. This was a cross-sectional observational study with data obtained from vaginal cervical samples for Pap smear and hybrid capture, colposcopy, and biopsy. The study included 86 females 12 years or older with a history of sexual activity. 10.7% of the women were diagnosed with cytological atypia and 28.6% were infected with high-risk HPV genotypes, which were more common among young women (mean = 25.6 years). Of these, 41.7% were positive for high-risk HPV genotypes 16 and/or 18 and/or 45, and the majority (58.3%) for other high-risk HPV genotypes. The study concludes that this group of indigenous women constitutes a special population, susceptible to develop precursor lesions for cervical cancer and vulnerable to STDs. Preventive measures are required, such as systematic cervical cancer screening and HPV immunization.

Validation of a quantitative food frequency questionnaire developed to under graduate students / Validacao de um questionario quantitativo de frequencia alimentar desenvolvido para universitarios

A validity test of a Food Frequency Questionnaire was carried out using 50 students of health occupation in São Paulo, Brazil. Therefore, a three day dietary record was used as reference method and variables such as energy, macronutrients and dietary fiber were analyzed. The accordance between the Food Frequency Questionnaire and average data from dietary record was tested with kappa statistics and intra-class correlation coefficients (ICC). Limits of agreement were estimated by the Bland-Altman's method. Better results were found for calories (ICC 0.43; 95%CI 0.17 - 0.63) and non-energy-adjusted nutrients, except dietary fiber (ICC 0.34; 95%CI 0.07 - 0.56). The percentage of individuals classified in the same category of consumption was nearly half (49.8%), while only 16% of them were classified in opposite categories. With the exception of lipids, other analyzed variables tended to be overestimated by the Food Frequency Questionnaire. The Food Frequency Questionnaire is recommended as a method of assessing food intake of university students in studies which focuson calorie estimates and also intend to classify groups into intake categories.

Validation of a quantitative food frequency questionnaire developed to under graduate students.

A validity test of a Food Frequency Questionnaire was carried out using 50 students of health occupation in São Paulo, Brazil. Therefore, a three day dietary record was used as reference method and variables such as energy, macronutrients and dietary fiber were analyzed. The accordance between the Food Frequency Questionnaire and average data from dietary record was tested with kappa statistics and intra-class correlation coefficients (ICC). Limits of agreement were estimated by the Bland-Altman's method. Better results were found for calories (ICC 0.43; 95%CI 0.17 - 0.63) and non-energy-adjusted nutrients, except dietary fiber (ICC 0.34; 95%CI 0.07 - 0.56). The percentage of individuals classified in the same category of consumption was nearly half (49.8%), while only 16% of them were classified in opposite categories. With the exception of lipids, other analyzed variables tended to be overestimated by the Food Frequency Questionnaire. The Food Frequency Questionnaire is recommended as a method of assessing food intake of university students in studies which focus on calorie estimates and also intend to classify groups into intake categories.

Grau de atividade física e síndrome metabólica: um estudo transversal com indígenas Khisêdjê do Parque Indígena do Xingu, Brasil / Degree of physical activity and metabolic syndrome: a cross-sectional study among the Khisêdjê group in the Xingu Indigenous Park, Brazil

Este estudo objetivou verificar a existência de associação entre o grau de atividade física e a presença de síndrome metabólica entre indígenas Khisêdjê. Foram avaliados 170 indivíduos com 20 anos ou mais. Obtiveram-se dados sociodemográficos, de testes físicos e análise de material biológico. Para análise dos dados, utilizou-se a estatística do qui-quadrado (p < 0,05), razões de prevalências (por ponto e por intervalo de 95% de confiança) brutas e ajustadas e teste t de Student. Resultados satisfatórios foram observados em relação aos testes de resistência cardiorrespiratória, flexibilidade, flexão de braço e tronco, além de na avaliação do nível de atividade física segundo o número de passos/dia. A prevalência de síndrome metabólica foi de 27,8%, sendo maior entre mulheres, entre indígenas nas faixas etárias de 39-49 anos e 50 anos ou mais e entre aqueles com desempenho inferior no teste de resistência cardiorrespiratória, impulso horizontal e número de passos/dia. Os resultados indicam a necessidade de maior vigilância no controle e prevenção dos fatores de risco que compõem a síndrome metabólica.

This study aimed to verify the existence of an association between degree of physical activity and presence of metabolic syndrome in the Khisêdjê indigenous group. The authors evaluated 170 individuals 20 years or older, based on demographic data, physical examination, and laboratory tests. The data were analyzed with the chi-square test (p < 0.05), crude and adjusted prevalence ratios (point and 95% confidence intervals), and Student's t-test. Satisfactory results were observed in relation to cardiorespiratory endurance, flexibility, bending of arms and trunk, and measurement of physical activity according to the number of steps/day. Prevalence of metabolic syndrome was 27.8% and was higher in women, the 39-49-year and ≥ 50-year age groups, and in individuals with lower performance on the cardiorespiratory endurance test, horizontal impulse, and number of steps/day. The results indicate the need for greater surveillance in the control and prevention of risk factors for metabolic syndrome.

[Spatial evolution of cardiovascular mortality in Paraná State, Brazil: 1989-1991 and 2006-2008]. / Distribuição espacial da mortalidade por doenças cardiovasculares no Estado do Paraná, Brasil: 1989-1991 e 2006-2008.

This ecological study aimed to describe the spatial distribution of cardiovascular mortality in Paraná State, Brazil (1989-1991 and 2006-2008) and its correlation with socioeconomic variables, using mortality data from the DATASUS database and population data from IBGE. Mortality rates were adjusted by the local empirical Bayesian method. Correlation analysis used the Moran I index and Spearman coefficient. There were no significant correlations or spatial dependence between mortality and socioeconomic variables. Mortality was higher in males in both periods. Cardiovascular mortality declined from 1989-1991 to 2006-2008 and was higher in females. Construction of thematic maps allowed visualization of the regions with highest cardiovascular risk. The decrease in mortality can be partially explained by expanded access to health services and improved living conditions and income.

Distribuição espacial da mortalidade por doenças cardiovasculares no Estado do Paraná, Brasil: 1989-1991 e 2006-2008 / Spatial evolution of cardiovascular mortality in Paraná State, Brazil: 1989-1991 and 2006-2008

Descrever a distribuição espacial da mortalidade por doença cardiovascular na população do Paraná, Brasil (1989-1991 e 2006-2008) e sua correlação com variáveis socioeconômicas. Trata-se de estudo ecológico, com dados de mortalidade e populacionais obtidos, respectivamente, do Departamento de Informática do SUS e do Instituto Brasileiro de Geografia e Estatística. As taxas de mortalidade foram ajustadas pela estimativa bayesiana empírica local. Utilizou-se o índice de Moran I e o coeficiente de Spearman na análise de correlação. Não foram observadas correlações significantes ou dependência espacial entre a mortalidade e as variáveis socioeconômicas. A magnitude da mortalidade foi maior no sexo masculino em ambos os triênios. A força de mortalidade por doenças cardiovasculares diminuiu entre 1989-1991 e 2006-2008, sendo maior no sexo feminino. A construção de mapas temáticos permitiu a visualização das macrorregionais com maior risco de ocorrência do agravo. A redução de mortalidade pode ser, em parte, explicada pelo maior acesso a serviços e pela melhoria das condições de vida e renda.

This ecological study aimed to describe the spatial distribution of cardiovascular mortality in Paraná State, Brazil (1989-1991 and 2006-2008) and its correlation with socioeconomic variables, using mortality data from the DATASUS database and population data from IBGE. Mortality rates were adjusted by the local empirical Bayesian method. Correlation analysis used the Moran I index and Spearman coefficient. There were no significant correlations or spatial dependence between mortality and socioeconomic variables. Mortality was higher in males in both periods. Cardiovascular mortality declined from 1989-1991 to 2006-2008 and was higher in females. Construction of thematic maps allowed visualization of the regions with highest cardiovascular risk. The decrease in mortality can be partially explained by expanded access to health services and improved living conditions and income.

Prevalence of metabolic syndrome in elderly Japanese-Brazilians.

BACKGROUND: Prevalence of individuals with a high cardiovascular risk is elevated in elderly populations. Although metabolic syndrome (MS) increases cardiovascular risk, information is scarce on the prevalence of MS in the elderly. In this study we assessed MS prevalence in a population of elderly Japanese-Brazilians using different MS definitions according to waist circumference cutoff values. MATERIAL/METHODS: We studied 339 elderly subjects, 44.8% males, aged between 60 to 88 years (70.1 ± 6.8). MS was defined according to criteria proposed by the Joint Interim Statement in 2009. As waist circumference cutoff point values remain controversial for Asian and Japanese populations, we employed 3 different cutoffs that are commonly used in Japanese epidemiological studies: 1) ≥ 90 cm for men and ≥ 80 cm for women; 2) ≥ 85 cm for men and ≥ 90 cm for women; 3) ≥ 85 cm for men and ≥ 80 cm for women. RESULTS: MS prevalence ranged from 59.9% to 65.8% according to the different definitions. We observed 90% concordance and no statistical difference (p>0.05) in MS prevalence between the 3 definitions. MS diagnosis according to all 3 cutoff values was found in 55.8% of our population, while in only 34.2% was MS discarded by all cutoffs. The prevalence of altered MS components was as follows: arterial blood pressure 82%, fasting glycemia 65.8%, triglyceride 43.4%, and HDL-C levels 36.9%. CONCLUSIONS: Elderly Japanese-Brazilians present high metabolic syndrome prevalence independent of waist circumference cutoff values. Concordance between the 3 definitions is high, suggesting that all 3 cutoff values yield similar metabolic syndrome prevalence values in this population.